OBJECTIVE: To determine whether a primary fitness program utilizing arm crank ergometry would cause increased shoulder pain in persons with spinal cord injury (SCI). DESIGN: Cohort study. SETTING: Clinical research center. PARTICIPANTS: People (n = 23) with chronic SCI (> 1 y) who were participating in a weight loss study to compare the effectiveness of diet only (1,000 kcal/d for 12 wk) versus diet with arm crank ergometry (1,000 kcal/d and arm crank ergometry 3 times a week for 12 wk). INTERVENTION: Arm crank ergometry. MAIN OUTCOME MEASURE: Changes in shoulder pain intensity using the Wheelchair User's Shoulder Pain Index (WUSPI). RESULTS: After adjusting for baseline scores, there was no significant difference between the 2 groups on postintervention WUSPI scores (F[1,20] = 0.85, p = 0.37, partial eta2 = 0.04). The strength of the relationship between group assignment (diet only versus diet and arm crank ergometry) and final WUSPI score was weak, as assessed by a partial eta2, with group assignment accounting for 4% of the variance on the WUSPI. The adjusted means were lower in the diet and arm crank ergometry group (mean 7.84) than in the diet only group (mean 12.22); however, these differences did not appear to be clinically significant. CONCLUSIONS: A primary fitness program using arm crank ergometry does not increase shoulder pain in people with SCI who use wheelchairs. Further investigation with a larger group and what constitutes clinically significant changes on the WUSPI is warranted to confirm our results.

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